Document Detail


Nonthyroidal illness syndrome and prolonged mechanical ventilation in patients admitted to the ICU.
MedLine Citation:
PMID:  19255297     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: The effect of the nonthyroidal illness syndrome (NTIS) on the duration of mechanical ventilation (MV) has not been extensively investigated. This study aims to determine whether the NTIS is associated with the duration of MV in patients admitted to the ICU. METHODS: We evaluated all patients admitted over a 6-year period to our ICU who underwent invasive MV and had measurement of serum free triiodothyronine (fT3), free thyroxine (fT4), and thyroid-stimulating hormone (TSH) performed in the first 4 days after ICU admission and, subsequently, at least every 8 days during the time they received MV. The primary outcome measure was prolonged MV (PMV), which was defined as dependence on MV for > 13 days. RESULTS: Two hundred sixty-four patients were included. Fifty-six patients (normal-hormone group) had normal thyroid function test results, whereas 208 patients (low-fT3 group) had, at least in one hormone dosage, low levels of fT3 with normal (n = 145)/low (n = 63) levels of fT4 and normal (n = 189)/low (n = 19) levels of TSH. Patients in the low-fT3 group showed significantly higher mortality and simplified acute physiology score II, and significantly longer duration of MV and ICU length of stay compared with the normal-hormone group. Two of the variables studied were associated with PMV, as follows: the NTIS (odds ratio [OR], 2.25; 95% confidence interval [CI], 1.18 to 4.29; p = 0.01); and the presence of pneumonia (OR, 1.17; 95% CI, 1.06 to 3.01; p = 0.03). CONCLUSION: The NTIS represents a risk factor for PMV in mechanically ventilated, critically ill patients.
Authors:
Giuseppe Bello; Mariano Alberto Pennisi; Luca Montini; Serena Silva; Riccardo Maviglia; Fabio Cavallaro; Antonio Bianchi; Laura De Marinis; Massimo Antonelli
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Publication Detail:
Type:  Journal Article     Date:  2009-03-02
Journal Detail:
Title:  Chest     Volume:  135     ISSN:  1931-3543     ISO Abbreviation:  Chest     Publication Date:  2009 Jun 
Date Detail:
Created Date:  2009-06-05     Completed Date:  2009-07-07     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0231335     Medline TA:  Chest     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1448-54     Citation Subset:  AIM; IM    
Affiliation:
Department of Anesthesiology and Intensive Care, Policlinico Universitario A. Gemelli, Università Cattolica del Sacro Cuore, Rome, Italy. gbello.gb@libero.it.
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MeSH Terms
Descriptor/Qualifier:
Age Distribution
Aged
Analysis of Variance
Cohort Studies
Critical Care / methods
Critical Illness / mortality,  therapy
Euthyroid Sick Syndromes / epidemiology*,  etiology*,  physiopathology
Female
Humans
Incidence
Intensive Care Units*
Length of Stay
Logistic Models
Male
Middle Aged
Multivariate Analysis
Probability
Prognosis
Respiration, Artificial / adverse effects*,  methods
Retrospective Studies
Risk Assessment
Sex Distribution
Statistics, Nonparametric
Survival Analysis
Thyroid Function Tests
Thyrotropin / blood
Time Factors
Chemical
Reg. No./Substance:
9002-71-5/Thyrotropin

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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